School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
Department of Epidemiology, Erasmus Medical Centre, 3015 GD, Rotterdam, The Netherlands.
BMC Public Health. 2020 Nov 6;20(1):1596. doi: 10.1186/s12889-020-09639-9.
Quality of life (QoL) is multi-dimensional concept of an individual' general well-being status in relation to their value, environment, cultural and social context in which they live. This study aimed to quantitatively synthesise available evidence on the association between QoL and mortality in the general population.
An electronic search was conducted using three bibliographic databases, MEDLINE, EMBASE and PsycINFO. Inclusion criteria were studies that assessed QoL using standardized tools and examined mortality risk in a non-patient population. Qualitative data synthesis and meta-analyses using a random-effects model were performed.
Of 4184 articles identified, 47 were eligible for inclusion, involving approximately 1,200,000 participants. Studies were highly heterogeneous in terms of QoL measures, population characteristics and data analysis. In total, 43 studies (91.5%) reported that better QoL was associated with lower mortality risk. The results of four meta-analyses indicated that higher health-related QoL (HRQoL) is associated with lower mortality risk, which was consistent for overall HRQoL (HR 0.633, 95% CI: 0.514 to 0.780), physical function (HR 0.987, 95% CI: 0.982 to 0.992), physical component score (OR 0.950, 95% CI: 0.935 to 0.965), and mental component score (OR 0.980, 95% CI: 0.969 to 0.992).
These findings provide evidence that better QoL/HRQoL was associated with lower mortality risk. The utility of these measures in predicting mortality risk indicates that they should be considered further as potential screening tools in general clinical practice, beyond the traditional objective measures such as body mass index and the results of laboratory tests.
生活质量（QoL）是个体在与其价值观、所处环境、文化和社会背景相关的一般健康状况的多维概念。本研究旨在定量综合现有关于一般人群中生活质量与死亡率之间关系的证据。
使用三个文献数据库（MEDLINE、EMBASE 和 PsycINFO）进行电子检索。纳入标准为使用标准化工具评估生活质量并在非患者人群中检查死亡率风险的研究。使用随机效应模型进行定性数据综合和荟萃分析。
在 4184 篇文章中，有 47 篇符合纳入标准，涉及约 120 万人。研究在生活质量测量、人口特征和数据分析方面存在高度异质性。共有 43 项研究（91.5%）报告称，生活质量越好，死亡率风险越低。四项荟萃分析的结果表明，较高的健康相关生活质量（HRQoL）与较低的死亡率风险相关，这对于总体 HRQoL（HR 0.633，95%CI：0.514 至 0.780）、身体功能（HR 0.987，95%CI：0.982 至 0.992）、身体成分评分（OR 0.950，95%CI：0.935 至 0.965）和心理成分评分（OR 0.980，95%CI：0.969 至 0.992）均一致。
这些发现提供了证据表明，更好的生活质量/HRQoL 与较低的死亡率风险相关。这些措施在预测死亡率风险方面的效用表明，它们应该在一般临床实践中进一步考虑作为潜在的筛查工具，而不仅仅是传统的客观措施，如体重指数和实验室检查结果。
